Abstract
An 80-year-old man had a black-blue nodule on his left cheek and its size increased to 7 mm diameter over the course of 1 year. Based on the clinical symptoms and dermoscopic findings, nodular melanoma, basal cell carcinoma or blue nevus was suspected. The nodule suddenly ruptured during the follow-up visits, and the lesion was suspected as basal cell carcinoma with hemangioma. A total resection biopsy was performed. Histopathological findings showed a pyogenic granuloma including intravascular papillary endothelial cell hyperplasia (IPEH). Pyogenic granulomas usually show vivid red to dark red color by dermoscopy. It is rare that pyogenic granuloma exhibiting a black-blue color as in our case. A rare observation with a black-blue color was speculated due to repeated recanalization of the thrombus by IPEH. A solid nodular lesion showing a black-blue color was recommended to perform a biopsy to confirm the diagnosis.
